How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.51 Typical High $1.51 | Professional | None | $1.00 | $1.51 | $1.51 |
Ambetter Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $1.51 | Facility | None | $0.79 | $0.79 | $1.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $1.00 Typical High $1.78 | Professional | None | $0.79 | $1.00 | $1.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.59 Median $0.79 Typical High $0.79 | Professional | UE · Used equipment | $0.59 | $0.79 | $0.79 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.63 | Facility | None | $2.51 | $2.51 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $8.71 | Professional | None | $0.89 | $0.89 | $8.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $5.37 Median $912.01 Typical High $2,187.76 | Facility | None | $5.37 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1.10 Median $1.38 Typical High $2.82 | Professional | None | $1.10 | $1.38 | $2.82 |
United Setting Professional Modifier None Typical Low $0.50 Median $0.87 Typical High $1.48 | Professional | None | $0.50 | $0.87 | $1.48 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.50 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.50 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.20 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.15 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.10 | $0.15 | $0.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.11 Typical High $0.14 | Professional | RR · Rental | $0.09 | $0.11 | $0.14 |
Where Indiana sits
The same service costs 2.5 times more in Idaho than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 29th of 51
$1.05
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.